Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome

• Published in: The journal of clinical endocrinology and metabolism 2020-10, Vol.105 (10), p.3346-3360
• Main Authors: Shang, Yujie, Zhou, Huifang, Hu, Minghui, Feng, Hua
• Format: Article
• Language: English
• Subjects: Blood Glucose - analysis; Blood Glucose - metabolism; Body composition; Body Mass Index; Body weight loss; Caloric Restriction; Care and treatment; Clinical trials; Complications and side effects; Counseling; Diet; Diet therapy; Dietary Approaches To Stop Hypertension; Dietary Services; Fasting; Fasting - blood; Female; Health aspects; Homeostasis; Humans; Hypocaloric diet; Insulin; Insulin - blood; Insulin - metabolism; Insulin resistance; Insulin Resistance - physiology; Laboratory testing; Metformin; Nutrient deficiency; Ovaries; Patients; Physiological aspects; Polycystic ovary syndrome; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - diet therapy; Polycystic Ovary Syndrome - metabolism; Reducing diets; Risk factors; Stein-Leventhal syndrome; Systematic review; Time Factors; Treatment Outcome; Weight Loss - physiology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgaa425

Abstract Objective The effect of diet on insulin resistance (IR) in polycystic ovary syndrome (PCOS) is controversial. Thus, we conducted this systematic review and meta-analysis to evaluate whether diet could reduce IR in women with PCOS while providing optimal and precise nutrition advice for clinical practice. Design The search was conducted in 8 databases through June 30, 2019. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A random-effects model was adopted to calculate the overall effects. Results A total of 19 trials (1193 participants) were included. The analysis showed that diet was significantly related to improvements in IR and body composition (eg, homeostasis model assessment of insulin resistance, fasting insulin, fasting plasma glucose, body mass index [BMI], weight, and waist circumference) in PCOS patients. The Dietary Approaches to Stop Hypertension diet and calorie-restricted diets might be the optimal choices for reducing IR and improving body composition, respectively, in the PCOS population. Additionally, the effects were associated with the course of treatment. The longer the duration, the greater the improvement was. Compared with metformin, diet was also advantageous for weight loss (including BMI and weight) and had the same effects on insulin regulation. Conclusion Overall, our findings suggest that diet is an effective, acceptable and safe intervention for relieving IR, and professional dietary advice should be offered to all PCOS patients.